Management of Systemic Steroid Therapy for Asthma: An Art Form Not Likely to be Replaced by Computer Decision Making

Abstract

Physicians who treat patients with severe asthma know that systemic corticosteroid medications represent a two-edged sword; steroids being not only the most potent treatment for asthma but also the most dangerous. The list of adverse side effects of these medications seems almost endless, ranging from irritability and increased appetite to adrenal suppression (including the possibility of adrenal insufficiency, especially during periods of stress), cataracts, osteoporosis, hypertension, electrolyte abnormalities, and myopathy.

Management of systemic steroid therapy is truly an art. There is no standard cookbook approach that can be applied to the average patient who requires this form of treatment. The art of steroid management includes knowing when to use the drug to minimize or avoid as many side effects as possible.